Details of a shake-up among some of the most senior officials at the Department of Health have emerged this week.
Two deputy directors of human resources were appointed to manage the directorate and lead implementation of the NHS HR strategy developed by HR director Hugh Taylor.
At the same time, it emerged that two senior officials reporting to new chief medical officer Professor Liam Donaldson are leaving.
Graham Winyard, who has been medical director of the NHS Executive and deputy CMO since 1993, will leave at Christmas to become postgraduate dean for Wessex.
Jeremy Metters, who has been deputy CMO since August 1989, will retire in June, when he reaches 60.
Dr Winyard admitted to HSJ that he was disappointed at not becoming CMO himself. 'I have been doing this job for five-plus years,' he said.
He described the Wessex post as a 'marvellous next move'. He will continue to chair the specialist workforce advisory group on medical workforce planning.
Dr Winyard wished Professor Donaldson success in his new appointment, and said he would make a 'first class' CMO.
There is less speculation about Dr Metters' departure, which has been planned for some time.
The role of CMO also came under the spotlight last week when Sir Donald Acheson, CMO from 1983 to 1991, told the official inquiry into BSE that he had spent 25 per cent of his time fighting off 'incessant' cuts in staff.
He claimed that his successors have had their independence 'compromised' by staff cuts and restructuring at the DoH. But Sir Donald said his work on BSE was given 'top priority'.
The new deputy directors of human resources are Steve Barnett and Bill McCarthy.
Mr Barnett, formerly director of human resources at Leicester General Hospital and Leicestershire HA, will be responsible for leading the implementation of the NHS HR strategy.
Mr McCarthy, who has led the DoH comprehensive spending review team since February 1997, will take on day to day management of the HR directorate.